Journal of midwifery & women's health最新文献

{"title":"Prevalence of Antenatally Identified Lactation Risk Factors and Risk of Not Fully Breastfeeding at 6 to 8 Weeks Postpartum.","authors":"Sharon L Perrella, Stuart A Prosser, Philip Vlaskovsky, Donna T Geddes","doi":"10.1111/jmwh.70006","DOIUrl":"https://doi.org/10.1111/jmwh.70006","url":null,"abstract":"<p><strong>Introduction: </strong>Several anatomical and endocrine factors have been linked to breastfeeding difficulties, yet there is limited evidence for their prevalence and associated postpartum breastfeeding outcomes. Knowledge of the prevalence and impact of nonmodifiable lactation risk factors can inform clinical care. We examined the prevalence of antenatally identifiable lactation risk factors and associated breastfeeding outcomes at 6 to 8 weeks postpartum.</p><p><strong>Methods: </strong>A retrospective study examined matched antenatal lactation risk screening data and infant feeding method at 6 to 8 weeks postpartum in a cohort of Australian women who gave birth at term gestation. The prevalence of lactation risk factors, associated full breastfeeding rates, and risk ratios for not fully breastfeeding at 6 to 8 weeks postpartum were calculated.</p><p><strong>Results: </strong>Screening data were obtained for 519 women; 408 were complete, and 296 had matched lactation outcome data. One lactation risk factor was identified in 65.4% (267 of 408) of women. Of those with no risk factors, 77.1% (81 of 105) were fully breastfeeding compared with 60.2% (115 of 191) with one risk factor, with a relative risk of not fully breastfeeding at 6 to 8 weeks of 1.69 (95% CI, 1.14-2.50). Other significant risk factors included gestational diabetes (GDM) (relative risk, 1.70; 95% CI, 1.24-2.34) and prepregnancy body mass index greater than or equal to 25 (relative risk, 1.74; 95% CI, 1.30-2.34); coexistence of these factors more than doubled the risk of not fully breastfeeding at 6 to 8 weeks postpartum (relative risk, 2.18; 95% CI, 1.58-3.01).</p><p><strong>Discussion: </strong>Nonmodifiable lactation risk factors may be identified in half of pregnant women. Previously identified risks of GDM and increased body mass index are compounded when they coexist, posing significant risks to early full breastfeeding outcomes. Antenatal identification of lactation risk factors offers opportunities to proactively educate and support women at risk to optimize breastfeeding and subsequent maternal and child health outcomes.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Medication Abortion Simulation for Midwifery and Women's Health Nurse Practitioner Students: Not Just Another Sim.","authors":"Carrie E Neerland, Melissa A Saftner, Stephanie Delkoski, Erin Galegher, Maria Ruud, Anne Woll, Joseph M Miller, David Melchionne-Martinez, Lou Clark","doi":"10.1111/jmwh.13786","DOIUrl":"https://doi.org/10.1111/jmwh.13786","url":null,"abstract":"<p><p>The US Supreme Court's 2022 decision in Dobb's v Jackson Women's Health Organization, which overturned Roe v Wade, has led to varying state-level restrictions and expansions in abortion access. In Minnesota, certified nurse-midwives and advanced practice registered nurses, including women's health nurse practitioners, were granted the ability to provide medication abortion. This expanded role necessitates comprehensive education to ensure students are equipped with the skills and confidence to provide high-quality abortion care. Simulation-based training, particularly using simulated patient (SP) methodology, offers an effective approach to preparing students for medication abortion care. An interprofessional team at the University of Minnesota School of Nursing developed an SP-based simulation curriculum to supplement midwifery and women's health student's training in medication abortion. The curriculum, designed using the Association of SP Educators' Standards of Best Practice, provided students with the opportunity to practice patient counseling, consent, and medication dispensing in a safe and supportive environment. The simulation was implemented with 20 midwifery and women's health students. Students highlighted the simulation's effectiveness in improving confidence, with some suggesting more detailed presimulation preparation. The SP-based simulation effectively enhanced students' perceived clinical skills and confidence in providing medication abortion care. The positive feedback emphasizes the value of SP-based simulation in preparing students for emerging clinical needs. Future improvements could include earlier didactic content and broader simulation scenarios. This innovation demonstrates the need for accessible and high-quality medication abortion care training to address disparities in health care access.</p>","PeriodicalId":94094,"journal":{"name":"Journal of midwifery & women's health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}